Staff at the South West Liver Unit, based at Plymouth Hospitals NHS Trust are running an exciting new trial of a drug that it is hoped will cure people suffering from Hepatitis C.
 
The drug, called TMC435, comes in tablet form and is taken in conjunction with the existing approved drugs that are used to treat Hepatitis C, Interferon and Ribavirin. A major difference between TMC435 and the existing Hepatitis C drugs is that it is designed to specifically target the Hepatitis C virus, while Interferon and Ribavirin are more general anti-virals. This combination means that patients who are treated with TMC435 can potentially receive a more effective and perhaps shorter course of treatment for Hepatitis C than the treatment that is currently on offer.
 
Dr. Matthew Cramp, Clinical Director of the South West Liver Unit and Consultant Hepatologist at Plymouth Hospitals NHS Trust said: “We are the only site outside London and one of just four in the UK that are running this trial. We have recruited patients to take part in the trial from across the southwest peninsula for whom conventional treatment has not worked, and who would potentially benefit the most from the new drug.”
 
Hepatitis C is a blood-borne virus that infects cells in the liver. It causes inflammation of the liver and eventually scarring, which in some cases can progress to cirrhosis, liver failure and liver cancer. The disease was discovered in 1989 and a screening process was developed in 1991 which made it possible to detect the Hepatitis C in blood samples. It is therefore a newly identified disease and there are many aspects of it that are still poorly understood.
 
Dr. Cramp continued: “There are several strains of the Hepatitis C virus and the commonest in the UK is genotype 1. The cure rate for patients with genotype 1 Hepatitis C is currently around 50%, with a year’s course of Interferon injections and Ribavirin tablets. Using new drugs, such as TMC435 in combination with interferon and ribavirin it is estimated that the cure rates could be as high as 70-80%, which is a big advance.
 
“We have been running the trial since Christmas and we are encouraged by the results so far. If it is successful, then there are plans to go ahead with a much larger international study involving hundreds of patients.”
 
Globally 180 million people are thought to have chronic Hepatitis C virus infection and it is estimated that around 250,000 people in the UK are infected. Symptoms of the disease can include fatigue, difficulty concentrating, nausea and joint pains. However, until the liver disease is severe, many of the symptoms are vague, subjective and often put down to something else, so it is estimated that around eight in ten sufferers of the disease do not actually know that they have it. People can often live for many years unaware that they have Hepatitis C, and as a result by the time they become ill and seek help considerable damage has often already been done to the liver.
 
Julian Bishop, a patient from Dartmouth who is taking part in the trial said: “I had been living with Hepatitis C for possibly as many as 30 years before I was formally diagnosed about five years ago. Interferon proved not to be very effective so I was put onto the clinical trial of TMC435 which is being run at Derriford Hospital.

“I feel very privileged to be taking part in the trial. I am hoping that the new treatment will work for me, and that if it proves effective that it will become widely available. It is also important that the profile of Hepatitis C is raised through events such as World Hepatitis Day on 19th May. With increased awareness, it is less likely that people will have to suffer with the disease for as long as I had to before receiving treatment.”

Hepatitis C is transmitted through exposure to blood that carries the virus, for example through transfusion of blood or blood products before Hepatitis C screening was available, sexual intercourse, shared personal care items (e.g. toothbrushes and razors) or intravenous drug use.